Individual provider Active NPI

Susan Marie Gniadek, APRN

  • Family Nurse Practitioner
  • Conway, SC
National Provider Identifier
1629594809
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
21600 Issued in SC
Practice address
2404 Wise Rd
Conway, SC 29526-5521
Phone
(843) 698-2663
NPI assigned
Aug 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 21600 SC Primary

Addresses

Primary practice location

2404 Wise Rd
Conway, SC 29526-5521

Mailing address

274 Penn Cir
Galivants Ferry, SC 29544-8679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180803001914 SC Practitioner - Nurse Practitioner 4789932971 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1314 3Rd Ave
Conway, SC 29526-5002
Phone (843) 848-6480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avenir Ventures, L.L.C. CurrentSince Apr 23, 2023 Accepting new patients
Lower Cape Fear Hospice Incorporated CurrentSince Nov 4, 2024 Accepting new patients
Avenir Ventures, L.L.C. CurrentSince Apr 23, 2023 Accepting new patients
Carelon Medical Partners, PC CurrentSince Apr 12, 2021 Accepting new patients
Lower Cape Fear Hospice Incorporated CurrentSince Nov 4, 2024 Accepting new patients

Locations

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

5959 S Sherwood Forest Blvd
Ste A
Baton Rouge, LA 70816

1414 Physicians Dr
Wilmington, NC 28401
Phone (910) 796-7900

615 Saint George Square Ct
Ste 300
Winston Salem, NC 27103
Phone (336) 793-8125

2201 Boundary St
Ste 112
Beaufort, SC 29902
Phone (842) 549-5166

1314 3rd Ave
Conway, SC 29526
Phone (843) 848-6480

220 N Main St
Ste 500
Greenville, SC 29601
Phone (347) 294-3414

333 Commerce St
Ste 700
Nashville, TN 37201
Phone (615) 627-2293

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1629594809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 PENN CIR",
            "city": "GALIVANTS FERRY",
            "state": "SC",
            "postal_code": "295448679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 WISE RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295265521",
            "telephone_number": "843-698-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GNIADEK",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-18",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "21600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, SC

Sources for this page

Verify at the official NPI Registry.